Think Family: Getting the whole picture Chris Cuthbert

1. Think Family: Getting the whole pictureChris Cuthbert

2. Contents • Who are families at risk and why do they matter? • What have we learned about support for families at risk? • What would a system that ‘Thinks Family’ look like? • How do we get there? • What can you do?

3. Who are Families At Risk? Economic well being Poverty and debt Worklessness Education and skills Most Excluded Families Health and family structures Crime and ASB Alcohol and drugs Poor housing and homelessness Domestic violence Relationship conflict Mental and physical health Communities and staying safe

4. The influence of family (and parents) is rarely neutralCommunities and staying safe • HOUSING • 51,060 families were accepted as homeless in 2006 • WHY IT MATTERS • Bad housing, overcrowding and homelessness is linked to poor mental and physical health for children and parents • Homelessness can lead to missed school for children and lower levels of engagement with services such as Sure Start • Homelessness can increase child vulnerability and increases the risk of a child being on the Child Protection Register from 1% to 12% • Number of children living in non-decent homes across the social and private rented sectors fell by 1.4 million between 1997-2005 • Since 2001, the number of non-decent homes in the social sector has reduced by over 50% • CRIME • Around 162,000 children have a parent in prison • 55% of female prisoners have a child under 16 • WHY IT MATTERS • Parental imprisonment disrupts contact between parent and child • Children of prisoners have about three times the risk for mental health problems and anti-social or delinquent behaviour compared to their peers • 63% of boys with convicted fathers go on to be convicted themselves • Crime has fallen by 44% since 1995, representing 8.4 million fewer crimes in total • ASB • 9,431 ASBOs issued between 1999-2005 • WHY IT MATTERS • Parents who engage in anti-social behaviour are more likely to raise children who also behave anti-socially • Children who know of their parents’ involvement in drug misuse or crime are at increased risk of misusing drugs and engaging in offending behaviour themselves • The Respect Action Plan (2006) focuses on addressing anti-social behaviour • Family Intervention projects are aimed at improving parenting and strengthening communities

6. Families experiencing multiple disadvantage • Basket of indicators of disadvantages includes: • No parent in the family is in work • Family lives in poor quality or overcrowded housing • No parent has any qualifications • Mother has mental health problems • At least one parent has a long-standing limiting illness, disability or infirmity • Family has low income (below 60% median) • Family cannot afford a number of food and clothing items Approximately 140,000 families with children experience 5 or more disadvantages Percentage of families with children experiencing 5 or more disadvantages 2.2 % 2.1 2 2 1.9 2001 2002 2003 2004 2005

7. Outcomes for children:Children from families facing multiple disadvantages are at greater risk of a range of negative outcomes Enjoy and achieve Make a positive contribution Source: Families and Children Survey (2004 and 2005)

8. Outcomes for childrenChildren from families facing multiple disadvantages are at greater risk of a range of negative outcomes Be Healthy Source: Families and Children Survey (2004 and 2005)

9. Outcomes for childrenChildren from families facing multiple disadvantages are at greater risk of a range of negative outcomes Stay safe Source: Families and Children Survey (2004 and 2005)

10. Contents • Who do we mean by families at risk? • What have we learned about support for families at risk? • What would a system that ‘Thinks Family’ look like? • How do we get there? • What can you do?

11. Why we need to ‘think family’ To build on family strengths – family belief systems, family cohesion and coping strategies can all have a major impact on how effectively family members are able to respond to adversity. The problems of the individual do not exist in isolation – Understanding the whole family situation can be highly important in diagnosing the root causes of a problem and in developing appropriate responses. Examples Family Group Conferencing (FGC) Family Intervention Projects (FIPs) Multi-systemic Therapy (MST) Family Nurse Partnership (FNP) Services and programmesServices that ‘think family’ can improve outcomes and help build family capital

12. Family Nurse Partnerships • Family Nurse Partnership Pilots • Structured home visiting programme for disadvantaged parents from pregnancy until child age two • Goals • Improve pregnancy outcomes • Improve child health and development and future school readiness and achievement • Improve parents’ economic self-sufficiency 30 years development and 3 large scale trials • Improvements in women’s prenatal health • Reductions in children’s injuries • Fewer subsequent pregnancies • Greater intervals between births • Increases in fathers’ involvement • Increases in employment • Reductions in welfare and food stamps • Improvements in school readiness £30m over the CSR period to expand the programme www.everychildmatters.gov.uk/parents/healthledsupport/

13. Family Intervention Projects The Dundee Families project, established in 1997 by the NCH charity, has successfully helped families with multiple disadvantages and who cause problems for their communities, supporting them to resolve their issues ranging from a lack of basic parenting skills to alcohol and drug addiction. 53 of these projects have now been rolled out across the country Key Components: • Dedicated key worker with low case load and persistent and assertive working style who takes the lead in engaging families and coordinating agencies and services • Whole family assessment which ensures the needs of the whole family are met and regularly reviewed • A contract which sets out the changes in behaviour that are expected and the support that will facilitate change • Intensive and structured support which enables key workers to engage, assess and focus intensively on their families for as long as is needed • A coordinated and integrated response where agencies commit to working together, sharing appropriate and relevant information, agreeing objectives and dedicating resources to resolve a client’s difficulties

14. The next piece in the puzzle?Adult services can play a key role in improving outcomes for children and families • Parenting supportPromoting effective parenting • Increased investment in parenting support • National Academy of Parenting Practitioners • Expansion of Family Intervention Projects • Children’s servicesInvesting in the individual child • ECM integration of children’s services • Investment in education • Expansion of early years provision Opportunities and outcomes for children and families • Adults’ services ? • Do adults’ services recognise and respond to the parental and family roles of their clients? • Are we exploiting the opportunities to tackle the parent-based drivers of poor child and family outcomes?

15. Systems reformThere are opportunities to improve outcomes by building on progress in systems reform The systems of support around families at risk are inadequate because they: • Are complex and highly fragmented • Intervene too late • Lack a focus upon the most at risk families Three key areas of opportunity for systems change: • Extending the logic of collaboration from Every Child Matters beyond children’s services to better coordinate all of the services working with families at risk • Capitalising on the reach and expertise of the public and third sectors to identify and intervene earlier to support families better • Ensuring we have effectiveservices to work with families and to address parent-based risks and getting the incentives right so that support reaches those who need it most

16. Working with families

17. Contents • Who do we mean by families at risk? • What have we learned about support for families at risk? • What would a system that ‘Thinks Family’ look like? • How do we get there? • What can you do?

18. Think Family: The key characteristics No wrong door Contact with any service offers an open door into a system of joined up support

19. Think Family: The key characteristics Look at the whole family Services working with both adults and children take into account family circumstances and responsibilities

20. Think Family: The key characteristics Build on family strengths Practitioners work in partnership with families recognising and promoting resilience and helping them to build their capabilities

21. Think Family: The key characteristics Provide support tailored to need Tailored and family-centred packages of support that knit together relevant interventions are offered to all families at risk

22. Contents • Who do we mean by families at risk? • What have we learned about support for families at risk? • What would a system that ‘Thinks Family’ look like? • How do we get there? • What can you do?

23. ECM and Children’s Trusts have introduced a dynamic for increased collaboration between children’s services DAT LSC Housing YOT Child Social Serv Child Health Outcomes for children and young people Child Leisure Youth CAMHS Police Schools Specialist Serv Vol orgs

24. However, systems around families facing multiple disadvantages are still highly fragmented DAT Advice services LSC Probation LSC DAT Housing YOT Adult Social Serv Adult Health Leisure Child Social Serv Child Health Adult Housing Child Leisure Youth JC+ CAMHS AMHS Police Police Vol orgs Schools Private orgs Specialist Serv Specialist Serv Vol orgs Prison

25. Opportunity to extend the logic of cooperation from ECM to encompass all services working with the family DAT Advice services LSC Probation LSC Housing YOT DAT Adult Social Serv Adult Health Leisure Child Social Serv Child Health Parent Family Housing Child Leisure Youth JC+ CAMHS AMHS Police Police Vol orgs Schools Private orgs Specialist Serv Specialist Serv Vol orgs Prison

26. 12-15 local Family Pathfinders £13m Family Pathfinders to test and develop the Think Family approach: • Aim to improve outcomes for families at risk, including those not being effectively engaged and supported by existing services • Build on ECM and encourage greater cooperation between children’s services and key adults’ services, including social care, employment, housing, adult mental health etc. • Develop locally led learning on how system change across adults’ and children’s services can improve support for vulnerable families • Tell us what works – and what needs to change • Share learning (e.g. linking into the LGA Narrowing the Gap network of LAs) £3m Extended Family Pathfinders for young carers: • 5-6 areas will extend their work to include systems and support services which will address directly and in more detail the support needs of families with young carers

27. Family Pathfinders: testing local systems change

28. What can you do? • Ask what more could be done in your area to ensure systems and services are truly ‘thinking family’? • Ask families about their experiences of services – what they like and what they want to see changed. • Talk to practitioners to find out what helps and what inhibits them from ‘thinking family’ • Let us know about innovative work with families in your area • Champion the ‘think family’ approach and...spread the word! For a Family Pathfinder application pack visit: www.everychildmatters.gov.uk/parents/pathfinders/ Deadline for receipt of bids 29th February 2008